白蛋白结合型紫杉醇与溶剂型紫杉醇治疗转移性乳腺癌的最小成本分析

摘要

目的：对白蛋白结合型紫杉醇与溶剂型紫杉醇治疗转移性乳腺癌的经济性进行比较，为临床治疗决策提供参考。方法：通过医院信息管理系统（HIS）调取2011年1月－2015年5月在北京大学肿瘤医院接受白蛋白结合型紫杉醇或溶剂型紫杉醇治疗乳腺癌患者的病历各15份，分别包括72和74个化疗周期，以每2次连续化疗周期为1个计量点，收集患者成本数据和临床疗效评价结果，计算两组患者的客观缓解率和不良反应发生例数，并进行药物经济学分析。结果：白蛋白结合型紫杉醇组患者较溶剂型紫杉醇组的客观缓解率更高，但差异无统计学意义（47.22％vs.37.84％，P＞0.05），且不良反应发生例数比较差异也无统计学意义（19例vs.16例，P＞0.05），因此采用最小成本分析法研究二者的经济性。白蛋白结合型紫杉醇的成本较溶剂型紫杉醇更高（37404.82元vs.17049.02元），且敏感度分析支持该结果。结论：白蛋白结合型紫杉醇的治疗效果略高于溶剂型紫杉醇，但后者更具有药物经济学优势，临床应根据患者具体情况选择用药。%OBJECTIVE:To compare the economics of albumin-bound paclitaxel vs. solvent-based paclitaxel in the treatment of metastatic breast cancer(MBC),and provide reference for clinical treatment decision making. METHODS:Medical records of 15 MBC patients receiving albumin-bound paclitaxel or solvent-based paclitaxel respectively were selected from HIS during Jan. 2011 to May 2015,including 72,74 chemotherapy cycles. Using every 2 consecutive cycles of chemotherapy as a measure point, cost data and the results of clinical efficacy evaluation were collected. Objective remission rate and the incidence of ADR were calculated, and pharmacoeconomic analysis was conducted. RESULTS:Compared with solvent-based paclitaxel, objective remission rate of was albumin-bound paclitaxel was higher,without statistical significance(47.22% vs. 37.84%,P>0.05);there was no statistical significance in the number of ADR cases(19 cases vs. 16 cases,P>0.05);cost-minimization analysis could be used to study the economics of them. The cost of albumin-bound paclitaxel was higher than that of solvent-based paclitaxel (37 404.82 yuan vs. 17 049.02 yuan), which was supported by sensitivity anlysis. CONCLUSIONS:Therapeutic efficacy of albumin-bound paclitaxel is slightly better than that of solvent-based paclitaxel,but the latter has pharmacoeconomic advantage. The drugs should be selected according to the condition of patients.